Structured Prompts for Describing One’s Clinical Style
Introduction: The following tool aims to help clinicians describe their usual therapeutic approach (e.g. degree of self-disclosure, how sessions are structured, what communication between sessions looks like). It can be shared with current or prospective patients/clients as a supplement to other information about a clinician's practice.
The purpose of this tool is not to identify a "right" way to practice therapy, but to help clinicians and patients better understand whether the clinician’s approach is likely to be a good fit for the patient’s unique situation and needs.
For the likert-scale questions, bolded values indicate the clinician’s default or most common setting, while highlighted blue values indicate the range of approaches a clinician is reasonably comfortable using.
Caveat #1: I realize that, in many cases, clinicians may adjust their approach based on the specific patient they are working with, their goals, etc. As such, the values below may correspond to a general “default” setting or typical range rather than being prescriptive of all approaches a clinician is capable of. Additionally, some of these settings may change over time.
Caveat #2: There is some subjectivity to scales– i.e. how a clinician defines “moderate self-disclosure” may be very different to how a patient/client defines “moderate self-disclosure”! Additionally, clinicians are human and – like all of us– may struggle to completely accurately evaluate themselves or their approach. To mitigate this, this tool tries to focus primarily on dimensions that don’t clearly have a “right” or “wrong” answer (i.e. some patients might benefit from a highly structured therapy approach while others might benefit from a more flexible approach.) However, this is only a partial solution, and unfortunately this tool is not able to guarantee safety or a good fit with a given clinician.
Clinical Style
Self-disclosure: how much a clinician typically shares about themselves.
1 2 3 4 5
Rarely use Frequently use
Optional note:
Session Structure: whether sessions are largely flexible/responsive to what is currently coming up for the patient or whether sessions are more structured around the patient's long-term goals or other clinical considerations.
1 2 3 4 5
(Sessions are primarily flexible) (Sessions are primarily structured)
Optional note:
Between-session homework or practice: how frequently activities or homework for in between sessions are suggested.
1 2 3 4 5
(Rarely suggests activities or homework) (Frequently suggests activities or homework)
Optional note:
Focus of therapy: whether therapy primarily focuses on current situations versus exploring past or formative experiences and their relationship to the present
1 2 3 4 5
(Primarily focuses on current situations) (Significant focus on past experiences)
Optional note:
Level of detail: whether the therapist primarily focuses on the bigger picture themes and patterns or whether the therapist primarily focuses on specific details and nuances.
1 2 3 4 5
(Big picture) (Specific details)
Optional note:
Emotional expression: whether the therapist is generally more emotionally reserved or emotionally expressive.
1 2 3 4 5
(Reserved) (Expressive)
Optional note:
Degree of challenge: whether the therapist is primarily validating and understanding or whether they tend to gently challenge the patient to encourage change.
1 2 3 4 5
(Validating) (Challenging)
Optional note:
Feedback: whether feedback is patient led (i.e. the patient can raise or not raise feedback or concerns, without additional prompts for feedback) or therapist led (i.e. the therapist proactively checks in with the patient about their needs and explicitly welcomes feedback periodically.)
1 2 3 4 5
(Patient led) (Therapist led)
Optional note:
Practice Logistics
Session start times. Which best describes your usual practice?
○ Sessions almost always begin on time.
○ Sessions occasionally begin a few minutes late.
○ Small delays are fairly common.
○ My schedule is currently somewhat unpredictable.
○ Other (please share):
(Optional explanation)
Session endings. Which best describes your usual practice?
○ Sessions almost always end at the scheduled time.
○ Sessions usually end on time but occasionally run a few minutes over when clinically appropriate.
○ I am generally fairly flexible with session length.
(Optional explanation)
Scheduling predictability. Life circumstances sometimes affect scheduling. Which best describes your current situation?
○ I do not currently anticipate major disruptions to my schedule.
○ There is some possibility that I may need to reschedule appointments more frequently than usual.
○ I currently expect my schedule to be somewhat unpredictable due to ongoing circumstances.
(Optional explanation)
Communication between sessions. Which best describes your usual approach?
○ No communication between sessions.
○ Scheduling or administrative messages only.
○ Limited clinical communication in specific situations.
○ Varies substantially depending on the patient or practice setting.
(Optional explanation)
Reflection
Situations where I am most likely to be a good fit.
What kinds of goals or therapeutic situations tend to be a particularly good fit for your usual approach?
Things patients may find challenging
Are there aspects of your practice that some patients find stressful, frustrating, or unexpected?
Examples might include a highly exploratory pace, significant between-session work, or external circumstances that occasionally affect scheduling.
Areas outside my scope
Are there therapeutic situations or goals that are generally outside your scope of practice?
Particular experience
Are there identities, communities, life experiences, or clinical situations where you feel you have particularly strong knowledge or experience?
Ruptures
How would you describe your approach to “ruptures” in therapy (for example, if a patient feels misunderstood, hurt, or dissatisfied with some aspect of treatment)?
